ABSTRACT
Background: Cerebrospinal fluid [CSF] leaks can arise as a complication of trauma, hydrocephalus, endoscopic sinus surgery or it may occur spontaneously without any identifiable cause. Surgical repair is recommended in patients who do not respond to the conservative management. In recent years transnasal endoscopic approach has become the preferred method for repairing the CSF leaks and better outcomes have been reported as compared to the intracranial approaches that were previously used. Objective of this study was to analyse the outcome of transnasal endoscopic repairof CSF rhinorrhoea. Methods: This prospective study was conducted in the Department of Neurosurgery, Ayub Medical College, Abbottabad, from March 2007 to March 2010. Twenty-one patients with CSF rhinorrhoea were included in study that were diagnosed on the basis of clinical evaluation, glucose concentration of nasal discharge, computed tomography [CT] and magnetic resonance imaging [MRI]. These patients did not respond to conservative management and were operated transnasally using rigid endoscope. Patients were followed up for a mean duration of 9 months and the outcome was analysed. Results: The patients included in the study ranged in the age group of 1255 years. Among the patients 13 [57%] were female and 8 [38%] were males. The cause of CSF rhinorrhoea was traumatic in 16 [76.19%], Idiopathic or spontaneous in 4 [19.04%] and 1 [4.7%] case was related to endoscopic surgery for pituitary macroedenoma. In 10 [47.6.8%] patients the site of leak was cribriform plate, 5 [23.8%] had from sphenoid, 4 [19.04%] from frontal sinus and in 2 [9.5%] Ethmoid was affected. Primary surgery was successful in 17 [80.95%] of cases. In 2 [9.5%] cases re-exploration had to be performed. In 1 patient re-exploration had to be done for the third time. Overall success rate was 95%. One patient presented with CSF leak and meningitis 1 month after surgery and unfortunately died. Conclusion: Transnasal endoscopic repair of CSF rhinorrhoea is highly successful, safe and less traumatic. Keywords: Transnasal endoscopic repair, CSF Rhinorrhoea, CSF leak, transnasal endoscopic duroplasty
ABSTRACT
Hepatitis C Virus [HCV], the causative agent of Hepatitis C is prevalent in different countries including Pakistan. Studies have been conducted on various aspects of HCV in Pakistan. The present study was planed to see the prevalence of hepatitis C in pregnant females of Hazara Division. Five hundred pregnant females of reproductive age group from Hazara Division selected by non probability convenient sampling technique were studied from 1st March 2006 to 28th February 2007 at Ayub Teaching Hospital, and District Headquarter Hospitals Abbottabad, Haripur and Mansehra. After initial serving by immunology technique positive cases were confirmed by Enzyme Linked Immunosorbant Essay [ELISA]. Seroprevalence of HCV in pregnant females of Hazara division was 8.9%. Females aged from 25-35 constituted the largest group among positive cases. HCV was more prevalent in District Abbottabad as compared to the other districts of Hazara division. Seroprevalence of HCV in pregnant females of Hazara Division is different from the figures already reported form the other parts of Pakistan
ABSTRACT
Hepatitis C is rapidly emerging as a major health problem in developing countries including Pakistan. The present study was conducted to document the frequency of Hepatitis C seropositive individuals reporting for hepatitis testing at a referral laboratory. Serum samples were collected from 614 people [436 males and 178 females] referred for chronic liver disease from all parts of Hazara division during the period July 2000 to July 2002. Hepatitis tests were performed by DOT immuno-chromatographic method for anti HCV antibodies. A total of 251 [40.8%] sera tested positive for anti HCV antibodies, including 184 males [73.3%] and 67 females [26.7%]. Of 436 males, 184 [42.2%] tested positive, while among females, 67/178 [37.6%] tested positive; this difference is not statistically significant. However the male/female ratio referred for testing was 2.4:1. There is a high frequency of HCV seropositive individuals of both sexes among patients referred for chronic liver disease. The frequencies obtained for Hazara division compare well with figures from other parts of Pakistan as well as developing countries. The male/female ratio could simply be a reflection of more males coming for treatment and testing in our setting
Subject(s)
Humans , Male , Female , Hepatitis C Antibodies , Liver Diseases/virology , Chronic DiseaseABSTRACT
Hepatitis B virus infection is one of the major health problems in the developing countries including Pakistan. The present study was conducted to document the frequency of Hepatitis B seropositivity in patients with chronic liver disease in the Hazara Division. Serum samples were collected form 893 patients suffering from chronic liver disease [CLD] from all parts of the Hazara Division during period July 2000 to July 2002. Hepatitis HBsAg was detected by the immunochromatographic method. A total of 271 [30.35%] tested positive for HBsAg including 199 males [73.43%] and 72 females [26.56%]. There is a high frequency of HBV seropositive individuals of both sexes among patients referred for chronic liver disease. These frequencies obtained for Hazara Division compare well with figures from other parts of Pakistan as well as developing countries